@ruralgal76- I'm glad that your Orencia is working and you're hanging in there. I've been on Estratest (estrogen and testosterone) since my hysterectomy at 40; so my bones aren't doing too badly yet- only one hip has significant osteopenia. My skin has taken a real beating though. Literally, I kind of look like an abused spouse, with constant bruising and my skin peels off if scratched which leaves a lot of scarring. Keep up with your dexa scans and be careful!